Blood Flow Restriction (BFR) Training: The Ultimate Guide To Better Pumps and Bigger Muscles

You can put gym-goers into different categories — beginners, advanced, and legends. Beginners must focus on learning the craft, experienced athletes use advanced training principles (such as super sets and drop sets), and legends use blood flow restriction (BFR) training.

But what is blood flow restriction training, you ask?

Bodybuilders often chase the pump. They perform each exercise with the goal of filling their target muscles with blood and lactic acid, which results in a muscle-ripping pump. A muscle pump represents an increase in intracellular hydration that causes the muscle fiber to swell.

Contrary to what most lifters think, the benefits of a pump go beyond short-term gratification. According to research, a muscle pump can increase muscle protein synthesis and decrease protein degradation, leading to bigger and stronger muscles. [1]

That said, most people find it near-impossible to achieve a muscle pump in every training session. If you are one of these folks and are on the brink of forgetting how a muscle pump feels, you should try blood flow restriction (BFR) training. 

In this article, we dive deep into blood flow restriction training, explore its main benefits, bust some common misconceptions about this training protocol, and take you over the step-by-step process of incorporating BFR into your training regimen.

What is Blood Flow Restriction (BFR) Training?

Blood flow restriction training is also known as occlusion training. It was conceptualized in Japan in the 1960s and was initially known as KAATSU training. BFR involves wrapping a pressure cuff, KAATSU device, or knee wraps around the top of a limb to create sufficient pressure to restrict blood flow out of the working muscle.[2][3]

During a BFR training set, blood enters your target muscles through the arteries; however, the pressure cuffs prevent its return to the heart through the veins. Subsequent sets result in more blood rushing into the working muscles, delivering a nasty muscle pump and igniting muscle hypertrophy. 

Using pressure cuffs can restrict your range of motion and make moving your limbs harder. Hence, you should use 20–30% of your one-rep max (1RM) during blood flow restriction training. Keep your rest durations between sets short, preferably 30 seconds, to ensure the blood stays in your target muscles. Resting for too long will give the blood enough time to escape. 

BFR training causes growth by enhancing metabolite buildup, a mechanism of muscle growth. These metabolic by-products would normally be ‘washed out’ by normal blood flow, but occlusion allows their accumulation. The metabolite (lactic acid) build-up helps stimulate muscle growth. [4][5]

You will also experience faster muscle fatigue with BFR training. This will push your central nervous system to engage the largest fast-twitch muscle fibers, which have the greatest capacity to grow. 

The most common misconception about BFR training

Many people mistake ‘blood flow restriction’ for ‘blood flow blocking’ training and go to town while tightening the cuffs. Tying the cuffs too tight will not only return suboptimal results but also increases your risk of injury. 

You are not supposed to completely cut off the blood supply to your target muscles while wrapping the cuffs. Tying the cuffs too tight will prevent the blood from entering your muscles, which beats the purpose of this technique. 

Loosen the cuffs if you feel numbness or a tingling sensation in your limbs. Discontinue training if you feel dizzy or uncomfortable. 

How Does BFR Training Work

Most lifters believe you must go all-out in the gym to achieve your dream physique. However, blood flow restriction training turns this concept on its head. BFR training requires you to use 20-30% of your 1RM and reduce your training intensity and volume. However, the results you achieve by incorporating BFR training into your routine are at power with the usual high volume and intensity workouts. 

Three main components lead to muscle growth:

Muscle Trauma

You must break your muscle tissues by overloading them to build stronger and bigger muscles. You can achieve this in the gym through resistance training. The amount of stress your muscles require will depend on your fitness level. Make consistent progress by incorporating progressive overload into your training regimen. 

Oxygen Depletion

Your body requires more oxygen during a heavy resistance training session. However, your muscles usually don’t receive enough oxygen while performing targeted high-intensity weight training exercises. Your body releases lactic acid to stimulate muscle hypertrophy to compensate for the lack of oxygen. Lactic acid is responsible for the burning sensation you experience during high-intensity exercise. 

Cellular Swelling

While training, your body rushes more blood to the target muscle group to ensure an optimal supply of oxygen and nutrients to sustain the activity and kickstart the recovery progress. During an intense exercise, there is an influx of a high amount of blood into your muscles, which causes the pump effect. This cellular swelling leads to muscle hypertrophy. 

Blood flow restriction training works on all three aspects. It causes muscle trauma, leads to oxygen depletion, and boosts cellular swelling, putting you on the path to strength and muscle gains. 

During a BFR exercise, blood enters your working muscles through your arteries. However, the pressure cuffs prevent them from leaving the muscles through the veins. Although all resistance training exercises lead to the three components of muscle growth, BFR training achieves it faster and uses much less volume and intensity, putting it in a league of its own. 

Since, during BFR training, your body assumes that it is handling much heavier weight than it actually is, it recruits the fast-twitch muscle fibers, which are otherwise only engaged while lifting close to your 1RM. Fast-twitch muscle fibers are larger and bulk up faster than the slow-twitch fibers engaged during high-volume, low-intensity exercises. 

Benefits of Blood Flow Restriction (BFR) Training

Adding BFR training into your exercise regimen entails the following advantages:

Incredible Muscle Pumps

BFR training is a must-try for people who have difficulty establishing a mind-muscle connection and achieving a muscle pump. The muscle pumps from BFR exercises are so intense you will have no idea what to do with your muscles to make them stop hurting. 

Faster Muscle Growth

Occlusion training allows the blood to fill up your target muscles but prevents it from escaping through the veins. The lactic acid build-up in the muscles helps stimulate muscle growth faster than conventional training, where these metabolites escape because of unrestricted blood flow. 

Allows You To Use Lighter Weights

Most intermediate and advanced lifters must go relatively heavy to achieve a muscle pump. However, BFR training allows them to achieve the same muscle-building and pump effects using 20-30% of their one-rep max. Plus, blood flow restriction training also improves your mind-muscle connection, which carries over to other exercises. 

Joint-Friendly

Going heavy on every exercise to stimulate muscle growth puts your joints under undue stress. Since BFR training requires you to lift significantly lighter weights, you will experience much less joint stress. Furthermore, incorporating BFR training into your exercise regimen is an excellent way to improve longevity. 

Great For Recovery Weeks

Advanced lifters generally cycle between heavy and light weeks. BFR training is an excellent training method to incorporate into your recovery weeks. You can also use it as an accessory lift during your heavy weeks. It helps you ignite muscle growth without requiring you to push too hard. 

Clinical Benefits

BFR training is often used by physiotherapists in athletes and recreational training to boost muscle hypertrophy. It is also implemented in the training routines of individuals who cannot do high-intensity exercise because of certain health conditions.

How To Implement Blood Flow Restriction (BFR) Training Into Your Exercise Regimen

Making the most of occlusion training requires you to master this technique. Here is a step-by-step guide to incorporating BFR training into your workout regime:

Equipment

BFR training requires you to tie a tourniquet around your limbs. The most common blood flow restriction training equipment includes blood pressure cuffs, KAATSU devices, and knee wraps. 

BFR cuffs are usually made of nylon or elastic. The wider cuffs mostly use nylon, whereas the narrow ones are elastic. Notably, elastic cuffs have been shown to provide significantly greater arterial occlusion pressure than nylon cuffs, which is not ideal for the results we are seeking with BFR training. [6]

You could also use a cotton bandage to achieve suitable metabolite buildup to ignite muscle growth. 

Wrap Width 

Although many gymgoers often use knee wraps during occlusion training, it is not ideal for achieving the desired results.

According to research, you should use wraps with a width of 5–9 cm, as it reduces the risk of occluding the arteries, which is often a risk with using bands that are wider than 13 cm. At the same time, a wrap that is too thin (less than 5 cm) may cause too much local pressure and tissue damage. [7]

You can find many specialized BFR wraps on the market, including specific upper and lower limb cuffs for the best fit. These bands should get a permanent spot in your gym bag if you are serious about blood flow restriction training. 

Wrapping Pattern

Lifters that use a long wrap, such as a knee or elbow wrap, for their BFR training usually wrap their limbs in a spiral manner. However, this leads to suboptimal results. You should always wrap at the top of your arms and legs in a layered way. 

Plus, using a spiral wrapping pattern will also limit your range of movement, which will restrict muscle fiber engagement. Use specialized pressure cuffs to ensure that you are applying the right pressure at the right place. 

Tightness

Most of the side effects associated with blood flow restriction training are associated with tying the bands too tightly, which restricts the veins and the arteries. However, as you know by now, our goal with BFR training is to restrict blood flow in the veins, but we want to leave the arteries almost unaffected. Arteries bring the blood from the heart to your muscles, while the veins take it back to the heart. [8]

The band tightness can be a complicated subject. These should be tight enough to impede venous return and allow blood pooling while allowing arterial inflow into the target muscle group. The band tightness can vary depending on the individual’s physique and experience level. More experienced lifters might require some trial and error before arriving at the correct pressure level. 

Since there is no scientific equipment in gyms to gauge the band pressure, you must use perceived pressure on blood flow to determine the tightness of the wraps. On a pressure scale of 0–10, where zero is no pressure at all and 10 represents maximum tightness, the perceived pressure while training legs should be a 7 out of 10. On the other hand, a perceived pressure of 6 on 10 is optimal to induce muscle pumps and hypertrophy while training your upper body. [9]

If you are torn between if the band is at a perceived tightness of eight, while it should be seven, it is always recommended to go a little loose than too tight. Research has shown that perceived pressure between 40% and 80% at 40% of 1RM produced the same muscle growth and strength gains. [10]

Site

You should always wrap at the top of your arms and legs. Many lifters tend to tie the bands around the top of their calves and forearms while training these muscle groups. However, this can lead to arterial blockage. 

Tying the bands around your upper arms and legs will have the same effect on your lower limbs. Furthermore, tying at the top of your limbs has also been shown to be effective while training your chest, shoulders, and glutes. 

Exercises

You can use BFR bands in compound and isolation exercises. We recommend alternating between these exercises in every workout to ensure overall development. Compound movement helps build muscle mass and strength, whereas isolation exercises improve muscle conditioning. 

Some of the most popular exercises used for BFR training include squat, barbell biceps curl, leg extension, calf raise, cable triceps extension, and leg press. You must ensure you follow a full range of motion while performing these exercises to get the best bang for your buck. 

Sets and Reps

BFR training requires you to perform a high number of repetitions (15-30). Doing at least 15 to 30 reps extends your time under tension and fills your muscles with blood. Plus, the bands restrict the blood from leaving your target muscles. [11]

Limiting your rest duration between sets is as important during BFR training as performing a high number of reps. Restrict your rest duration between sets to 30 seconds to ensure that you are accumulating enough blood in your muscles to ignite hypertrophy. 

Furthermore, you must keep the cuffs on during the rest periods. Taking off the cuffs will allow the trapped blood to rush back to the heart and the lactic acid to be flushed out. You can achieve an even more intense pump by hitting bodybuilding poses and contracting your muscles as hard as possible during the rest duration. 

Progressive Overload

Progressive overload involves gradually increasing the intensity, weight, frequency, or number of repetitions in your strength training routine. Incorporating progressive overload into your training regimen is a must if you want to make consistent progress and avoid hitting a plateau. 

Although BFR training requires you to lift between 20–30% of your 1RM, you shouldn’t stick to the same number of reps, sets, and intensity for all your workouts. BFR training will help you get stronger, which should consistently push up your 1RM. You must adjust your BFR training weight according to your new and improved 1RM every week. 

You can also combine BFR training with advanced training techniques, such as super sets, drop sets, and intraset stretching, and take your training intensity to the next level. These techniques will help you avoid hitting an overhead ceiling. 

How Often Should You Implement BFR Training Into Your Bodybuilding Program?

Since BFR causes very little muscle damage, you can incorporate it into your training regimen multiple times a week. There are three ways of programming blood flow restriction into your workouts. 

First, you can use it on your recovery days, when you’ll perform a limited number of exercises. You can also incorporate it as an accessory lift, as it allows you to use significantly less weight without compromising on hypertrophy. Finally, you can use it as a finisher in your conventional bodybuilding-style workout. [12]

That said, blood flow restriction is an advanced training protocol and should be treated like one. Use this training technique 1-3 times weekly to get the most out of it. It will ensure optimal muscle stimulation, and limiting its use will ensure your muscles don’t get used to it.

Can BFR Training Be Used For The Chest, Back, and Shoulders?

Since BFR training involves tying pressure cuffs around your arms and legs, most people assume that you can only use this training technique for training your limbs. This, however, is not the case. You can train your chest, back, shoulders, and glutes using blood flow restriction training. 

Your body works as a complete unit and not in isolation. You’ve probably experienced this when you are experiencing lower back pain. Your sitting and standing posture changes to compensate for the external stimulus, that is, the pain and discomfort. 

Tying pressure cuffs around your muscles while weight training sends your nervous system into a frenzy. Your CNS senses extreme fatigue during blood flow restriction training and fires up the supporting muscles to chip in and support your effort. 

A study found that performing the bench press while wearing pressure cuffs around your arms resulted in a 16 percent greater pec activation. Hence, you can achieve a better mind-muscle connection and pumps while training your chest using BFR training. [13]

You can also incorporate BFR training into your workouts while training two muscle groups in the same workout. For example, you can wear the pressure cuffs for the last chest and shoulder workout exercise for optimal muscle stimulation.

Tips To Improve Blood Flow Restriction (BFR) Training Results

Use the following tips to maximize your results from BFR training:

Incorporate BFR Training Into Your Recovery Days

Most advanced lifters switch between high-intensity weeks and recovery weeks. Recovery weeks require them to pull back their training intensity to allow their muscles time to recover. However, you must still hit the gym as per your schedule. 

High-intensity training often results in strength and muscle gains, and pulling back after noticing your gains can feel limiting. Many lifters are tempted to push harder than they should during their recovery weeks to challenge themselves, which can increase their risk of injury by not allowing them proper rest. 

Using BFR training in your recovery days can help keep your training intensity high without requiring you to push your boundaries on the sets, reps, and weights. Incorporating BFR training into your workout gives your muscle, joints, tendons, and ligaments a much-needed break and helps you maintain muscle and strength gains. 

Rest and Recovery

Since blood flow restriction doesn’t cause significant muscle damage, you can use this training technique multiple times weekly. We recommend limiting BFR training to three times a week, preferably done on alternate days, as it will provide your muscles with enough stimulation for growth. The limited exposure to BFR training will also ensure that your muscles don’t get used to this training style and won’t stop responding. 

Furthermore, you should limit your rest duration between BFR sets to 30 seconds for optimal muscle stimulation. Resting for more than 60 seconds will allow the trapped blood and metabolites to escape, which will hamper your growth potential. 

Common Mistakes During BFR Training

Stay clear of the following BFR training mistakes to reduce the risk of injury: 

Using Incorrect Cuff Pressure

Some lifters tend to tie the pressure cuffs too tight in hopes of getting the best results from BFR. However, this only increases your risk of injury. Tie the BFR bands between a perceived pressure point of six and seven to induce muscle pumps and hypertrophy while training your upper and lower body. Remember, it is always better to tie the cuffs a little loose than tie them too tight. 

Tying The Cuffs at the Wrong Place

It is common for newbies to tie the BFR cuffs at the top of their lower legs and forearms. However, this is not optimal as it can also affect arterial blood flow. You must always tie the cuffs at the top of your limbs for optimal results. Furthermore, wrapping the cuffs around your lower limbs can limit your range of motion, which can have counterproductive results. 

Overtraining

It is easy and common to overextend yourself while trying something new, especially when it shows quick results. Most people experience muscle-ripping pumps while trying the BFR bands for the first time, which convinces them to use these cuffs in each training session. Doing this, however, can lead to overtraining, increasing your risk of injury. Plus, using this training technique too often can make your muscles get used to the stimulus, resulting in a plateau. 

Improper Warm-Up

Because blood flow restriction training requires you to use weights that are 20–30% of your 1RM, many people skip warming up their target muscles before a workout and move the BFR sets to the front of their training session. 

Although you can do the BFR sets at the beginning of a workout, doing so without a warm-up is asking for trouble. Start your workouts with 5-10 minutes of warm-up, followed by 10-15 reps with 5-10% of your 1RM while wearing the bands to prime your muscles. 

Poor Training Form

Lifting while wearing pressure cuffs can throw your training form for a spin. Plus, wrapping the bands incorrectly can further restrict your range of motion. Compromising your form by wrapping the bands incorrectly or going too heavy significantly increases your risk of injury. 

To get the best bang for your buck from BFR training, you must perform your BFR sets with a picture-perfect form. Readjust the wrap tightness, location, and weights until you can complete the exercise with the correct form. 

Potential Risks and Safety Concerns While BFR Training

Here are a few risks and safety concerns associated with blood flow restriction training:

Wearing BFR Bands For Too Long

Some lifters wear the blood flow restriction cuffs for most of their workouts, which can negatively impact their blood flow. A prolonged restricted blood flow poses far greater health risks than suboptimal muscle and strength gains. Keeping your pressure cuffs on for too long can lead to numbness in your limbs, a tingling sensation, and dizziness. You are also at risk of fainting if you overlook these symbols. 

Wear the BFR bands for eight to 20 minutes in a single stretch. If you perform multiple BFR exercises in a single workout that take you more than 20 minutes to complete, take off the cuffs between the exercises and wait for at least five minutes before moving on to the next exercise. 

Chances of Nerve Impingement

Although the chances of nerve impingement are relatively low during blood flow restriction, you must use proper cuff placement and keep an eye out for irregular sensations. Folks with nerve-related conditions or sensitivities should avoid BFR training. 

You can minimize nerve impingement chances during BFR training by starting with a conservative cuff pressure and gradually increasing your blood flow restriction training intensity, volume, and frequency. 

Individuals That Should Abstain From BFR Training

Despite its effectiveness, blood flow restriction training is not for everyone. The following group of people should avoid BFR training: 

• Cancer patients
• Folks with blood clotting issues
• People dealing with bone fracture
• Individuals with infection of any kind (blood, skin, and vascular)
• Pregnant women

FAQs

Is BFR training safe?

Blood flow restriction training is absolutely safe when performed under suitable conditions, using appropriate equipment, exercises, and loads. Ensure you follow the correct technique to get the best bang for your buck and minimize the risk of injury. That said, folks dealing with health issues must get clearance from their physician before starting an exercise program. 

Should you warm up before a BFR set?

Absolutely! You must warm up before every workout. Spend 10-15 minutes warming up your muscles before a training session using a combination of static and dynamic movements. You should also perform a lightweight set of 15-20 reps without the pressure cuffs before doing the BFR sets. 

Does BFR training require more recovery time than conventional exercises?

Although BFR training leads to more significant muscle fatigue post-exercise than conventional lifts, there is no increase in muscle damage or decrease in power output after 24 hours. Your body takes almost the same time to recover from BFR training as the traditional movements. Hence, you need the same amount of time to recover from BFR training as conventional training. [14]

Wrapping Up

Many gym-goers find it impossible to achieve a muscle pump. Bodybuilding without muscle pumps is like an unflavored whey protein; it will get the job done but lacks fun. Blood flow restriction training will help you achieve muscle-ripping pumps. Plus, it can speed up your progress, which might make everyone think you’ve got a cheat code for building muscle. 

BFR training tricks your body into thinking that you are training harder than you are, which is excellent for people that despise weight training but want to improve their overall strength and muscle mass. So, what are you waiting for? Grab those pressure cuffs and get lifting. Best of luck!

References

1. Schoenfeld, Brad J. PhD, CSCS, CSPS, NSCA-CPT1; Contreras, Bret MA2. The Muscle Pump: Potential Mechanisms and Applications for Enhancing Hypertrophic Adaptations. Strength and Conditioning Journal 36(3):p 21-25, June 2014. | DOI: 10.1097/SSC.0000000000000021 
2. Wilson JM, Lowery RP, Joy JM, Loenneke JP, & Naimo MA (2013). Practical Blood Flow Restriction Training Increases Acute Determinants of Hypertrophy Without Increasing Indices of Muscle Damage. J Strength Cond Res, epub ahead of print.
3. Loenneke JP, Abe T, Wilson JM, Ugrinowitsch C, & Bemben MG (2012) Blood flow restriction: how does it work?Front Physiol, 3, 392.
4. Takarada Y, Nakamura Y, Aruga S, Onda T, Miyazaki S, and Ishii N. Rapid increase in plasma growth hormone after low-intensity resistance exercise with vascular occlusion. J Appl Physiol 88: 61–65, 2000.
5. Takano H, Morita T, Iida H, Asada K, Kato M, Uno K, Hirose K, Matsumoto A, Takenaka K, Hirata Y, Eto F, Nagai R, Sato Y, and Nakaajima T. Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow. Eur J Appl Physiol 95: 65–73, 2005
6. Buckner SL, Dankel SJ, Counts BR, Jessee MB, Mouser JG, Mattocks KT, Laurentino GC, Abe T, Loenneke JP. Influence of cuff material on blood flow restriction stimulus in the upper body. The Journal of Physiological Sciences. 2017 Jan 1;67(1):207-15.
7. Loenneke JP, Abe T, Wilson JM, Ugrinowitsch C, & Bemben MG (2012) Blood flow restriction: how does it work? Frontiers in Physiology, 3, 392.
8. Kacin, A., & Strazar, K. (2011). Frequent low-load ischemic resistance exercise to failure enhances muscle oxygen delivery and endurance capacity. Scandinavian Journal of Medicine & Science in Sports, 21(6), e231-e241.
9. Lowery RP, Joy JM, Loenneke JP, de Souza EO, Machado M, Dudeck JE, Wilson JM. Practical blood flow restriction training increases muscle hypertrophy during a periodized resistance training programme. Clinical physiology and functional imaging. 2014 Jul;34(4):317-21.
10. Takarada, Y., Takazawa, H., Sato, Y., Takebayashi, S., Tanaka, Y., & Ishii, N. (2000). Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans. Journal of Applied Physiology, 88(6), 2097-2106.
11. Wernbom, M., Paulsen, G., Nilsen, T. S., Hisdal, J., & Raastad, T. (2012). Contractile function and sarcolemmal permeability after acute low-load resistance exercise with blood flow restriction. European Journal of Applied Physiology, 112(6), 2051-2063.
12. Goto, K., Nagasawa, M., Yanagisawa, O., Kizuka, T., ISHII, N., & Takamatsu, K. (2004). Muscular adaptations to combinations of high-and low-intensity resistance exercises. The Journal of Strength & Conditioning Research, 18(4), 730-737.
13. Yasuda, T., Fujita, S., Ogasawara, R., Sato, Y., & Abe, T. (2010). Effects of low-intensity bench press training with restricted arm muscle blood flow on chest muscle hypertrophy: a pilot study. Clinical Physiology and Functional Imaging, 30(5), 338-343.
14. Wilson, J. M., Lowery, R. P., Joy, J. M., Loenneke, J. P., & Naimo, M. A. (2013). Practical blood flow restriction training increases acute determinants of hypertrophy without increasing indices of muscle damage. The Journal of Strength & Conditioning Research, 27(11), 3068-3075.

---